My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0012496
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
COUNTRY CLUB
>
2575
>
2900 - Site Mitigation Program
>
PR0541989
>
ARCHIVED REPORTS XR0012496
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/21/2019 9:12:27 PM
Creation date
6/21/2019 4:50:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012496
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
31
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SHELL OIL COMPANY MWCHAIN OF CUSTODY RECORD Date s, 75 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No Page 7--o1 <br /> Site Address <br /> -L-77 L, , , 1,t, Sfc Analysis Required LAB <br /> WIC# <br /> } l+ CHECK ONF(1)BOX ONLY CT1DT TURN AROUND TIME <br /> G W Monitoring ❑ 4491 <br /> Shell Engineer Phone No t ," 24 bows C1z J5-7,//,j ` Shelnvesll2alion ,Rr-4441 <br /> � Fax# /; /ti (;I 7Z \ti SO4Clam elly/Dlsposai ❑ 4442 4Bhaxs <br /> Consultant Name r Address �,)r;, WL> ' j O c N Water 15 days /�1��} <br /> 'F (Normal) <br /> J / c aD Y Ciassil/Dls sal ❑ 4443 ❑ <br /> L r U�'-�L[ �y.�f G ! L' [I�L'��1CL= �f 1 (1 _1L�._. X J y Other <br /> 'Zo su tant Co act« Ph C o 11(1/ O V SoWAlr Rem or Sys <br /> � �gG1tC�r' l��la,i���r rw r✓�l(C (n A m � Oars ❑ 4452 <br /> _ Fax # ' YJG 7�-x i� T ad � <br /> NOTE Not!!y Lab as <br /> 4 0 ❑ � rWater Rem or Sys anon as possible of <br /> Comments Ai rV.�� s1I��� O w OEM El 4453 24149 Iva TAT <br /> Ped �-Y t i.,/1( O rn s @ aver E)Sam ! b��, <br /> co � a ro 1 rn UST AGENCY. <br /> Printed N rn d L w_ w_ m `o C s y MATERIALSAMPLE <br /> i No of x tj <br /> E13- DESCRIPTION CONDITION/ <br /> Sample ID Dale Sludge Sod Water Air cauls pD 7 �c' q m <br /> U a COMMENTS <br /> lieiln ulslled By(slgnalure) Printed Namie_�, ?ae Ci ecsl d natur I /� Pd to Name Date tr 0 <br /> Q-Y d[tz — Timeetln Ish y(RIO ature) Prlt Name 1 elved(sig ure) Printed Name Dale <br /> L+t G YYdC l Time_ _ Time <br /> F1 nquished B slgnatuie) Printed Name Dale Recely d(signature) ] PrintsName Date <br /> Time / �eu Time <br /> D O FAUST PROVIDE A COPY OFTRIS CHAIN CUSTODYWITH INVOICE AN <br /> _ THE LABORATORY RY — <br /> REV 4/1/93 SHELL OIL COMPANY CHAIN OF CUSTODY <br />
The URL can be used to link to this page
Your browser does not support the video tag.